Modern marriage, men's extramarital sex, and HIV risk in Southeastern Nigeria

American Journal of Public Health

Volumn 97, Issue 6, 2007, Pages 997-1005

  Smith, Daniel Jordan ^a  

^a BROWN UNIVERSITY   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ACQUIRED IMMUNE DEFICIENCY SYNDROME; AMBIVALENCE; ARTICLE; CONTROLLED STUDY; FEMALE; HUMAN; HUMAN IMMUNODEFICIENCY VIRUS INFECTION; INFECTION RISK; LIFESTYLE MODIFICATION; MAJOR CLINICAL STUDY; MALE; MARRIAGE; MASCULINITY; MEDICAL DECISION MAKING; MORALITY; NIGERIA; SEX DIFFERENCE; SEXUAL BEHAVIOR; SOCIAL STRUCTURE; SOCIOECONOMICS; ADULT; CONDOM; DISEASE TRANSMISSION; INTERVIEW; MIDDLE AGED; PSYCHOLOGICAL ASPECT; SEXUALLY TRANSMITTED DISEASE; SOCIAL CLASS; UTILIZATION REVIEW;

ADULT; CONDOMS; EXTRAMARITAL RELATIONS; FEMALE; HIV INFECTIONS; HUMANS; INTERVIEWS; MALE; MARRIAGE; MEN; MIDDLE AGED; MORALS; NIGERIA; SEXUALLY TRANSMITTED DISEASES, VIRAL; SOCIAL CLASS;

EID: 34250875040     PISSN: 00900036     EISSN: 15410048     Source Type: Journal    
DOI: 10.2105/AJPH.2006.088583     Document Type: Article

References (60)

1. Nigeria Federal Ministry of Health, Technical Report on the 2003 HIV Sero-Prevalence Sentinel Survey among Pregnant Women Attending Antenatal Clinics in Nigeria (Abuja, Nigeria: Nigeria Federal Ministry of Health, 2004);
2. PAHO, "Fact Sheet: Gender and HIV/AIDS," http://www.paho.org/ english/hdp/hdw/GenderandHIVFactSheetI.pdf (accessed November 3, 2005);
3. UNIFEM, "Gender Dimensions of HIV/AIDS in India," in Summaries of Community-based Research on the Gender Dimensions of HIV/AIDS (New York, 2001), 8-10;
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5. J. R. Glynn et al., "HIV Risk in Relation to Marriage in Areas With High Prevalence of HIV Infection," Journal of Acquired Immune Deficiency Syndromes 33(2003): 526-535;
6. J. R. Glynn et al. "Why Do Young Women Have a Much Higher Prevalence of HIV Than Young Men? A Study in Kisumu, Kenya and Ndola, Zambia," Journal of Acquired Immune Deficiency Syndromes 15, suppl 4 (2001): S51-S60.
7. Andrea Cornwall, "Spending Power: Love, Money, and the Reconfiguration of Gender Relations in Ada-Odo, Southwestern Nigeria," American Ethnologist 29, no. 4 (2002): 963-980;
8. I.O Orubuloye, John Caldwell, and Pat Caldwell, "The Cultural, Social and Attitudinal Context of Male Sexual Behavior in Urban South-West Nigeria," Health Transition Review 5 (1997): 1195-1207;
9. Daniel Jordan Smith, "'Man No Be Wood': Gender and Extramarital Sex in Contemporary Southeastern Nigeria," Ahfad Journal 19, no. 2 (2002): 4-23.
10. Dorothy Hodgson and Sheryl McCurdy, eds, "Wicked" Women and the Reconfiguration of Gender in Africa (Portsmouth, NJ: Heinemann and James Currey, 2001).
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16. Caroline Bledsoe and Giles Pison, eds, Nuptuality in Sub-Saharan Africa: Contemporary Anthropological and Demographic Perspectives (Oxford: Clarendon Press, 1994);
17. Daniel Jordan Smith, "Having People: Family, Fertility and Modernity in Igbospeaking Nigeria" (PhD dissertation, Emory University, 1999);
18. Daniel Jordan Smith, "Romance, Parenthood and Gender in a Modern African Society," Ethnology 40, no. 2 (2001): 129-151.
19. Barbara Harrell-Bond, Modern Marriage in Sierra Leone: A Study of the Professional Group (Paris: Mouton, 1975);
20. Gustav Jahoda, "Love, Marriage and Social Change: Letters to the Advice Column of a West African Newspaper," Africa 29 (1959): 177-190;
21. Kenneth Little and Anne Price, "Some Trends in Modern Marriage Among West Africans. Africa and Change," Africa 37, no. 4 (1967): 407-423;
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23. Emmanuel Obiechina, An African Popular Literature: A Study of Onitsha Market Pamphlets (Cambridge: Cambridge University Press, 1973);
24. Kamene Okonjo, "Aspects of Continuity and Change in Mate-Selection Among the Igbo West of the River Niger," Journal of Comparative Family Studies 13, no. 3 (1992): 339-360.
25. Smith, "'Man No Be Wood,'" 4-23;
26. W.W. Karanja, "'Outside Wives' and 'Inside Wives' in Nigeria: A Study of Changing Perceptions," in Transformations in African Marriage, ed. David Parkin and David Nyamwaya (Manchester, UK: International African Institute, 1987), 247-262;
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28. T.O. Lawoyin and U. M. Larsen, "Male Sexual Behavior During Wife's Pregnancy and Postpartum Abstinence Period in Oyo State, Nigeria," Journal of Biosocial Science 34, no. 1 (2002): 51-63;
29. T.M. Mitsunaga, A. M. Powell, N. J. Heard, and U. M Larsen, "Extramarital Sex Among Nigerian Men: Polygyny and Other Risk Factors," Journal of Acquired Immune Deficiency Syndrome 39, no. 4 (2005): 478-488.
30. Smith, "'Man No Be Wood,'" 4-23;
31. Uche Isiugo-Abanihe, "Extramarital Sexual Relations and Perceptions of HIV/AIDS in Nigeria," Health Transition Review 4 (1994) : 111-125;
32. I.O. Orubuloye, John Caldwell, and Pat Caldwell, "Perceived Male Sexual Needs and Male Sexual Behavior in Southwest Nigeria," Social Science and Medicine 44, no. 8 (1997): 1195-1207.
33. For more on the relationship between mobility, men's extramarital sexual behavior, and HIV/AIDS in Africa, see Catherine Campbell, "Migrancy, Masculine Identities and AIDS: The Psychosocial Context of HIV Transmission on the South African Gold Mines," Social Science and Medicine 45, no. 2 (1997): 273-281;
34. J.T. Boerma et al., "Sociodemographic Context of the AIDS Epidemic in a Rural Area in Tanzania with a Focus on People's Mobility and Marriage," Sexually Transmitted Infections 78, Suppl 1(2002): i97-i105;
35. N. Lydie et al., "Mobility, Sexual Behavior, and HIV Infection in an Urban Population in Cameroon," Journal of Acquired Immune Deficiency Syndromes 35, no. 1 (2004): 67-74.
36. Some research suggests that reports linking HIV transmission to patterns of male migration have been exaggerated. See, for example, M. Lurie et al., "Migrancy and HIV/AIDS in South Africa - A Rural Perspective," South African Medical Journal 87, no. 7 (1997): 908-909.
37. Cornwall, "Spending Power," 963-980;
38. Smith, "'Man No Be Wood,'" 4-23;
39. for interesting perspectives on sugar daddies in other African contexts, see Mark Hunter, "The Materiality of Everyday Sex: Thinking Beyond 'Prostitution,'" African Studies 61, no. 1 (2002): 99-120;
40. Mark Hunter, "Cultural Politics and Masculinities: Multiple-Partners in Historical Perspective in KwaZulu-Natal," Culture, Health and Sexuality 7, no. 4 (2005): 389-403;
41. Jennifer Cole, "Fresh Contact in Tamatave, Madagascar: Sex, Money and Intergenerational Transformation," American Ethnologist 31, no. 4 (2004): 573-588;
42. Liz Walker, "Men Behaving Differently: South African Men since 1994," Culture, Health and Sexuality 7, no. 3 (2005): 225-238;
43. Nancy Luke, "Confronting the 'Sugar Daddy' Stereotype: Age and Economic Asymmetries and Risky Sexual Behavior in Urban Kenya," International Family Planning Perspectives 31, no. 1 (2002): 6-14.
44. For an excellent general theoretical treatment of masculinity, see R.W. Connell, Masculinities (Cambridge, UK: Polity, 1995).
45. For scholarship more directly focused on the relationship between masculinity and the HIV/AIDS epidemic, see Purnima Mane and Peter Aggleton, "Gender and HIV/AIDS: What Do Men Have to Do with It?" Current Sociology 49 (2001): 23-37;
46. Kim Rivers and Peter Aggleton, Men and the HIV Epidemic (New York: UNDP, 1999).
47. It is important not to overemphasize this point. The fact that most men want to keep their affairs secret from their wives is partly the result of the fact that husbands know there will be consequences if wives find out - consequences that the women themselves can impose. Several men and women in the study recounted the ways that women punished and curtailed men's infidelities, including withholding food, withdrawing financial support, preventing sexual access, and on much rarer occasions, publicly humiliating them or even retaliating with affairs of their own. Women are by no means powerless pawns in these modern Igbo marriages, but they have good reason to keep secrets or stay silent about their husbands' extramarital sexual behavior.
48. None of the men in the marital case studies admitted to visiting brothels or patronizing commercial sex workers, perhaps an indication of the perceived moral differences between extramarital sexual relations that involve having a girlfriend and paying for a prostitute. There are, of course, numerous brothels and large numbers of sex workers in southeastern Nigeria. Given that condom use is associated with promiscuous sex and immoral partners, it is likely that condoms are more easily acceptable for sex with sex workers. As part of the study, I interviewed half a dozen sex workers in Owerri, and all of them indicated that the vast majority of their clients agreed to use condoms.
49. For studies that explore the relationship between obstacles to condom use and HIV risk in Africa, see Daniel Jordan Smith, "Youth, Sin and Sex in Nigeria: Christianity and HIV-related Beliefs and Behaviour Among Rural-Urban Migrants," Culture, Health and Sexuality 6, no. 5 (2004): 425-437;
50. Idem., "Premarital Sex, Procreation and HIV Risk in Nigeria," Studies in Family Planning 35, no. 4 (2004): 223-235;
51. Idem., "Imagining HIV/AIDS: Morality and Perceptions of Personal Risk in Nigeria," Medical Anthropology 22, no. 4 (2003): 343-372;
52. William Adih and Cheryl Alexander, "Determinants of Condom Use to Prevent HIV Infection Among Youth in Ghana," Journal of Adolescent Health 24, no. 1 (1999): 63-72;
53. Abigail Harrison, Nonhlanhla Xaba, and Pinky Kunene, "Understanding Safe Sex: Gender Narratives of HIV and Pregnancy Prevention by Rural South African School-Going Youth," Reproductive Health Matters 9, no. 17 (2001): 63-71;
54. Lynn Hillier, Lyn Harrison, and Deborah Warr, "When You Carry Condoms All the Boys Think You Want It: Negotiating Competing Discourses about Safe Sex," Journal of Adolescence 21, no. 1 (1998): 15-29;
55. Catherine MacPhail and Catherine Campbell, "'I Think Condoms Are Good but Aai, I Hate Those Things': Condom Use Among Adolescents and Young People in a Southern African Township," Social Science and Medicine 52, no. 11 (2001): 1613-1627;
56. Eleanor Preston-Whyte, "Reproductive Health and the Condom Dilemma: Identifying Situational Barriers to Condom Use in South Africa," in Resistances to Behavioral Change to Reduce HIV/AIDS Infection in Predominately Heterosexual Epidemics in Third World Countries, ed. John Caldwell et al. (Canberra: Australian National University, 1999), 139-155;
57. Christopher Taylor, "Condoms and Cosmology: The 'Fractal' Person and Sexual Risk in Rwanda," Social Science and Medicine 31, no. 9 (1990): 1023-1028.
58. The high cost of getting married is contributing to a perceived crisis of masculinity in many African settings, including southeastern Nigeria. Important scholarship on this issue includes Hunter, "Cultural Politics and Masculinities," 389-403;
59. Adeline Masquelier, "The Scorpion's Sting: Youth, Marriage and the Struggle for Social Maturity in Niger," Journal of the Royal Anthropological Institute 11, no. 1(2005): 59-83;
60. Uche Isiugo-Abanihe, "Consequences of Bridewealth Changes for Nuptuality Patterns Among the Ibo of Nigeria," in Nuptuality in Sub-Saharan Africa: Contemporary Anthropological and Demographic Perspectives, ed. Caroline Bledsoe and Giles Pison (Oxford: Clarendon Press, 1994), 74-91.